COVID-19 Updates & Alerts 05/15/20

If you have already received funds, please go to the provider portal found at:
https://covid19.linkhealth.com/#/step/1

1. Complete Step one  ( Eligibility) Yes or No question
2. Complete Step two Enter TIN (Tax ID Number) for all TIN’s for which you received payment.
   • You may enter up to 20 TINs.  You may submit additional, separate requests with the same email address for additional TINs.
   • Each TIN must be 9 digits with no spaces, hyphens dashes.
   • Multiple TINs should be separated by commas.
3. Complete Step 3 Verify Payment Information
   • Enter last 6 digits of account number and EXACT relief fund payment amount for the TIN.

When the provider completes the Payment Verification and clicks continue, they will be redirected to the CARES Act Provider Relief Fund Application in DocuSign

4. Complete Step Authentication
   • Click Begin to be directed to next step.
   • Provider will be directed to the authentication page where they will enter the access code that they received in their email as part of the above registration process. Enter the access code and click Validate.
   • The provider will receive an email from CARES ACT Provider Relief Fund Application in DocuSign with the subject line: Email Validation:CARES Act Provider Relief Fund.
   • The provider can click the Resume Signing button within the email confirmation page to relaunch the PowerForm Authentication Page.
   • The application will open and the provider will need to select Continue in the upper right hand corner to access the document.
5. Filling out the application
   • Reference ID will automatically populate in top right hand corner of application
   • Provider will need to complete all items in RED
   • Fields with Gray boxes are optional
   • Tool tips and additional instructions will appear as you hover over each field.
   • TINS will automatically populate in application.  This is based on the providers entry of Business TINs in the portal in a previous step.  (They are un-editable).
   • Primary Practice Address and Payment Address Fields are required.
   • Revenue Section
     • The fields in the Revenue section are dynamic and will populate based on the providers selection in Federal Tax Classification
     • See Appendix A for matrix ( use this chart as a reference for completing the form)
     • Example: If Sole Proprietor/Disregarded Entity (LLC) is selected, the provider will be asked to enter the appropriate data and attach the required tax form
     • To attach a document, the provider should click on the yellow tag, click Upload A File, select the file from their local or shared drive, then click DONE
   • Complete the Request / Provider Relief Consent
     • Initial the consent by clicking the on initial field / Adopt and Initial
     • Once all actions are completed, click Finish at the end of document or the top right of the page.
     • After provider has finished the application a completion email will be sent to the provider.
     • The completed documents can be seen by clicking the “View Completed Documents link on email.

To access the Complete User Guide on CARES Act Provider Relief Fund click the below link:
https://chameleoncloud.io/review/2977-5ea0af98f0fd0/prod